Healthcare Provider Details

I. General information

NPI: 1639767627
Provider Name (Legal Business Name): MISS MAGGIE BETH MCGINLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2021
Last Update Date: 01/18/2024
Certification Date: 01/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

412 INVESTORS PL STE 102
VIRGINIA BEACH VA
23452-1185
US

IV. Provider business mailing address

4120 BENJAMIN HARRISON DR
VIRGINIA BEACH VA
23452-1917
US

V. Phone/Fax

Practice location:
  • Phone: 855-444-9838
  • Fax:
Mailing address:
  • Phone: 757-738-2057
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: